Wiki Claims Data

[TNelson1031]

Hello AAPC members,

I've been tasked with finding some claims data form numerous private insurers from different states across the country. The thing is, from experience I know, if you don't have a specific claim number, NPI or tax ID you can't get through to payer's CS or Claims departments.

Is there another avenue to finding this information? An example of what I'm seeking, I want to find out how many claims Cigna processed for CY 2016, for Oral appliances for sleep apnea and CPAP claims..

All information and concerns are greatly appreciated.

Best,
Tiffany

 

[thomas7331]

Although you may be able to find this kind of data publicly available for government payers, I believe that private payers would most likely consider this information proprietary and confidential and will be reluctant to share this unless you enter a formal agreement with them specifying how you are going to use that information. If you are conducting research for an academic or journalistic purposes, you might try contacting the payers' communications or press departments and see if they have anything published, or any way you can obtain compiled data from them. Or alternatively, I'd also suggest looking at some of the publications by think tanks, professional societies and other research organizations that work with this kind of information (e.g. Kaiser Family Foundation, www.kff.org, which has a real wealth of healthcare data on their web site) and you may be able to find that some of the information you need is already compiled and available from their work. Hope this helps some.

 

[TNelson1031]

Although you may be able to find this kind of data publicly available for government payers, I believe that private payers would most likely consider this information proprietary and confidential and will be reluctant to share this unless you enter a formal agreement with them specifying how you are going to use that information. If you are conducting research for an academic or journalistic purposes, you might try contacting the payers' communications or press departments and see if they have anything published, or any way you can obtain compiled data from them. Or alternatively, I'd also suggest looking at some of the publications by think tanks, professional societies and other research organizations that work with this kind of information (e.g. Kaiser Family Foundation, www.kff.org, which has a real wealth of healthcare data on their web site) and you may be able to find that some of the information you need is already compiled and available from their work. Hope this helps some.

This information helped tremendously!

Thank you for your help

-Tiffany